Refractory Coeliac Disease; Role of Nigella sativa as Immunomodulator

Aim: The aim of this study was to assess the immunological and histological profiles of adult coeliac patients after commencing Nigella sativa (NS) oil with gluten free diet (GFD) for a period of 1 year ± 1month to prove its validity in treatment of refractory coeliac disease (CD). Methodology: Thirty two adult coeliac patients who all accepted to do endoscopy and duodenal biopsy in addition to serological assessment before and after treatment of GFD alone or with NS oil capsules for a period of 1 year ± 1 month. Duodenal biopsies were interpreted histologically according to modified Marsh criteria and the sera were tested for antigliadin antibody (AGA), anti tissue transglutaminase antibody (tTG) and endomysium antibody (EMA). Results: The response to gluten withdrawal with NS oil for a period of 1 year ± 1 month in CD patients was better than GFD alone with significant response to serological markers. Conclusion: The administration of NS oil with GFD to CD patients leads to a significant decreases more than GFD alone in the levels of all immunological parameters with histological improvement and stop the disease process (P=0.001). Ultimately, the results emerging from this study may substantially improve the immunotherapeutic application of NS in clinical management of refractory CD cases.